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Review
. 2023 Oct 30;15(21):5209.
doi: 10.3390/cancers15215209.

Harnessing Ferroptosis to Overcome Drug Resistance in Colorectal Cancer: Promising Therapeutic Approaches

Affiliations
Review

Harnessing Ferroptosis to Overcome Drug Resistance in Colorectal Cancer: Promising Therapeutic Approaches

Xiaofei Cheng et al. Cancers (Basel). .

Abstract

Drug resistance remains a significant challenge in the treatment of colorectal cancer (CRC). In recent years, the emerging field of ferroptosis, a unique form of regulated cell death characterized by iron-dependent lipid peroxidation, has offered new insights and potential therapeutic strategies for overcoming drug resistance in CRC. This review examines the role of ferroptosis in CRC and its impact on drug resistance. It highlights the distinctive features and advantages of ferroptosis compared to other cell death pathways, such as apoptosis and necrosis. Furthermore, the review discusses current research advances in the field, including novel treatment approaches that target ferroptosis. These approaches involve the use of ferroptosis inducers, interventions in iron metabolism and lipid peroxidation, and combination therapies to enhance the efficacy of ferroptosis. The review also explores the potential of immunotherapy in modulating ferroptosis as a therapeutic strategy. Additionally, it evaluates the strengths and limitations of targeting ferroptosis, such as its selectivity, low side effects, and potential to overcome resistance, as well as challenges related to treatment specificity and drug development. Looking to the future, this review discusses the prospects of ferroptosis-based therapies in CRC, emphasizing the importance of further research to elucidate the interaction between ferroptosis and drug resistance. It proposes future directions for more effective treatment strategies, including the development of new therapeutic approaches, combination therapies, and integration with emerging fields such as precision medicine. In conclusion, harnessing ferroptosis represents a promising avenue for overcoming drug resistance in CRC. Continued research efforts in this field are crucial for optimizing therapeutic outcomes and providing hope for CRC patients.

Keywords: colorectal cancer (CRC); drug resistance; ferroptosis; immunotherapy; treatment strategies.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Classic signaling pathways of ferroptosis. Illustration depicting the fundamental signaling pathways associated with ferroptosis. The figure outlines the canonical GPX4-regulated pathway, focusing on the role of GPX4 in lipid peroxide reduction, the iron metabolism pathway elucidating the iron-dependent aspects of ferroptosis, and the lipid metabolism pathway highlighting lipid peroxidation and its contribution to cell membrane rupture. These interconnected pathways underscore the multifaceted nature of ferroptotic cell death. The figures were created using the Figdraw software (https://www.figdraw.com, accessed on 13 August 2023).
Figure 2
Figure 2
Mechanisms of drug resistance reversal through ferroptosis targeting. This figure illustrates diverse molecular interactions and sites of action for various agents aimed at reversing drug resistance through ferroptosis modulation. In the diagram, red text denotes sites of action for agents targeting ferroptosis reversal in chemotherapy, blue text represents sites of action for agents targeting ferroptosis reversal specifically, and green text indicates sites of action for agents targeting ferroptosis reversal in immunotherapy. The integrated approach to targeting these pathways highlights their potential synergistic effects in overcoming drug resistance. The figures were created using the Figdraw software (https://www.figdraw.com, accessed on 13 August 2023).

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